Purpose: :
Cataracts are the leading cause of blindness in developing countries.Despite the success of modern cataract surgery, worldwide cataractblindness is increasing and not decreasing. Clearly, a new approachto visually disabling cataract is needed. This study was undertakento determine the potential image quality on the retina of aneye treated with a novel interventional approach to cataractswhereby a pinhole device is placed through the opacified insitu lens.

Methods: :
The Liou and Brennan nominal eye model was modified by creatinga pinhole aperture at the midpoint of the crystalline lens.Modulation transfer function plots were used in this model toestimate Snellen acuity for far, intermediate and near fieldsof vision. 16.9 million light rays were analyzed for differentpinhole sizes.

Results: :
With a pinhole diameter of 0.18 millimeters, potential Snellenvisual acuity is in the 20/70 to 20/100 range. Larger pinholesizes led to lower predicted Snellen acuities. Estimating theamount of light on the retina reveals a reduction from 2% ofnormal, as is seen in a dense cataract, to 0.2% for the 0.18millimeter pinhole system. Larger pinholes let in more light.

Conclusions: :
This study demonstrated that a pinhole device deployed intoa cataractous lens could generate clinically meaningful andmuch improved Snellen acuity. The image quality with the optimalpinhole size would be washed out by incident flux unless thisissue is directly addressed in the novel treatment system. Furthertechnical development is underway to create a new, easily performedtechnique that can play a role in eradicating global cataractblindness.